Percutaneous Manual Aspiration Thrombectomy Followed by Stenting for Iliac Vein Compression Syndrome with Secondary Acute Isolated Iliofemoral Deep Vein Thrombosis: A Prospective Study of Single-session Endovascular Protocol

Zhu, Qiaohua; Zhou, Chengyu; Chen, Y.; Wang, J.; Mo, Hongyan; Luo, Meihua; Huang, Wei; Yu, Xin-Fa

doi:10.1016/j.ejvs.2013.09.030

Cited by 35 publications

(29 citation statements)

References 23 publications

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“…26 Since then, catheter-delivered thrombolytics and percutaneous mechanical thrombectomy, either with or without angioplasty and stent placement, has been standard of care for patients symptomatic with MTS. 6,24,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] Studies that have evaluated stenting of the left common iliac vein report low morbidity, no mortality, a long-term high patency rate, and a low rate of in-stent restenosis. 35,[43][44][45][46][47][48][49][50][51][52] Postoperative therapy for MTS includes anticoagulation for at least 3 months to prevent rethrombosis, and a retrievable inferior vena cava filter may also be considered for patients with a preexisting pulmonary embolism.…”

Section: Overvie W Of May-th Urner Syndome (Mts) Pathophys Iology Amentioning

confidence: 99%

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Harbin

Lutsey

2020

Journal of Thrombosis and Haemostasis

100

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Patients with May‐Thurner syndrome (MTS) are at elevated risk of developing an extensive left iliofemoral deep vein thrombosis (DVT; localized blood clot) due to an anatomical variant where the right common iliac artery compresses the left common iliac vein against the lumbar spine. While MTS was initially presumed to be rare when it was first anatomically defined in 1957, case reports of this syndrome have recently become more frequent, perhaps due to improved imaging techniques allowing for enhanced visualization of the iliac veins. Still, the population burden of this condition is unknown, and there is speculation it may be higher than generally perceived. In the present review, we (a) review history of how MTS became recognized, (b) describe practical challenges of studying MTS in population‐based settings due to the specialized imaging required for diagnosis, (c) discuss why the contribution of MTS to DVT may be underestimated, (d) describe uncertainty regarding the degree of venous compression which leads to DVT, and (e) outline future research needs. Our goal is to raise awareness of MTS and spark additional research into the epidemiology of this condition, which may be an underappreciated causative venous thromboembolism risk factor.

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Section: Overvie W Of May-th Urner Syndome (Mts) Pathophys Iology Amentioning

confidence: 99%

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Harbin

Lutsey

2020

Journal of Thrombosis and Haemostasis

100

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“…CT with intravenous contrast in a transverse plane has proven to be a useful modality in confirming the diagnosis of MTS [14,18,20] . A CT examination of the abdomen or pelvis can rule out extrinsic reasons of compression as well as identify acute DVT and collateral pathways; however, a normal CT with 10-mm cuts cannot always establish a diagnosis of MTS because small iliac spurs are often too difficult to visualize and fibrosis can conceal the underlying vasculature [7,8,21] .…”

Section: Ctmentioning

confidence: 99%

Iliac vein compression syndrome: Clinical, imaging and pathologic findings

Brinegar

Sheth

Khademhosseini

et al. 2015

WJR

106

149

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May-Thurner syndrome (MTS) is the pathologic compression of the left common iliac vein by the right common iliac artery, resulting in left lower extremity pain, swelling, and deep venous thrombosis. Though this syndrome was first described in 1851, there are currently no standardized criteria to establish the diagnosis of MTS. Since MTS is treated by a wide array of specialties, including interventional radiology, vascular surgery, cardiology, and vascular medicine, the need for an established diagnostic criterion is imperative in order to reduce misdiagnosis and inappropriate treatment. Although MTS has historically been diagnosed by the presence of pathologic features, the use of dynamic imaging techniques has led to a more radiologic based diagnosis. Thus, imaging plays an integral part in screening patients for MTS, and the utility of a wide array of imaging modalities has been evaluated. Here, we summarize the historical aspects of the clinical features of this syndrome. We then provide a comprehensive assessment of the literature on the efficacy of imaging tools available to diagnose MTS. Lastly, we provide clinical pearls and recommendations to aid physicians in diagnosing the syndrome through the use of provocative measures.

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“…After screening 793 studies for eligibility, 37 studies reporting 45 treatment effects (nonthrombotic, [12][13][14][15][16][17][18][19] AT, 13,18,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] and CPT 12,14,17,30,33,34,[37][38][39][40][41][42][43][44][45][46][47][48] ) from 2869 unique patients (nonthrombotic, 1122; AT, 629; and CPT, 1118) were included in the meta-analysis. The most common reasons for study exclusion were lack of relevant stent placement outcomes (19 studies), kin relationships (18 studies), sample size <10 (16 studies), combined outcome reporting in nonthrombotic and thrombotic patients (8 studies), and combined outcome reporting in AT and CPT patients (6 studies).…”

Section: Study Selectionmentioning

confidence: 99%

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction

Razavi

Jaff

Miller

2015

Circ: Cardiovascular Interventions

201

117

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Background-Endovenous recanalization of iliofemoral stenosis or occlusion with angioplasty and stent placement has been increasingly used to maintain long-term venous patency in patients with iliofemoral venous outflow obstruction. The purpose of this systematic review and meta-analysis was to determine safety and effectiveness of venous stent placement in patients with iliofemoral venous outflow obstruction. Methods and Results-We searched MEDLINE and EMBASE for studies evaluating safety or effectiveness of stent placement in patients with iliofemoral venous outflow obstruction. Data were extracted by disease pathogenesis: nonthrombotic, acute thrombotic, or chronic post-thrombotic. Main outcomes included technical success, periprocedural complications, symptom relief at final follow-up, and primary/secondary patency through 5 years. A total of 37 studies reporting 45 treatment effects (nonthrombotic, 8; acute thrombotic, 19; and chronic post-thrombotic, 18) from 2869 patients (nonthrombotic, 1122; acute thrombotic, 629; and chronic post-thrombotic, 1118) were included. Technical success rates were comparable among groups, ranging from 94% to 96%. Complication rates ranged from 0.3% to 1.1% among groups for major bleeding, from 0.2% to 0.9% for pulmonary embolism, from 0.1% to 0.7% for periprocedural mortality, and from 1.0% to 6.8% for early thrombosis. Patient symptom relief data were reported inconsistently. At 1 year, primary and secondary patency were 96% and 99% for nonthrombotic, 87% and 89% for acute thrombotic, and 79% and 94% for chronic post-thrombotic. Conclusions-Stent Methods Literature SearchThis study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. 9 We searched MEDLINE and EMBASE for randomized or nonrandomized controlled studies and prospective or retrospective case series of stent placement for treatment of iliofemoral venous outflow obstruction by using a combination of relevant keywords. The details of the MEDLINE search strategy are listed in Table I in the Data Supplement. The syntax for EMBASE was similar, but adapted as necessary. In addition, manual searches were conducted using the Directory of Open Access Journals, Google Scholar, and the reference lists of included papers and relevant meta-analyses. No date restrictions were applied to the searches. The final search was conducted March 15, 2015. Study SelectionTwo researchers independently selected studies for inclusion in the review. Disagreements were resolved by consensus. Titles and abstracts were initially screened to exclude review articles, commentaries, letters, case reports, and obviously irrelevant studies. Full texts of the remaining articles were retrieved and reviewed. Main inclusion criteria included studies with (1) primary diagnosis of obstructive lesions of the common femoral vein, external iliac vein, and the common iliac vein, (2) stent placement in the common femoral vein, external iliac vein, common iliac vein, and the inferior vena cava, (3) outcomes reporte...

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Percutaneous Manual Aspiration Thrombectomy Followed by Stenting for Iliac Vein Compression Syndrome with Secondary Acute Isolated Iliofemoral Deep Vein Thrombosis: A Prospective Study of Single-session Endovascular Protocol

Cited by 35 publications

References 23 publications

May‐Thurner syndrome: History of understanding and need for defining population prevalence

May‐Thurner syndrome: History of understanding and need for defining population prevalence

Iliac vein compression syndrome: Clinical, imaging and pathologic findings

Safety and Effectiveness of Stent Placement for Iliofemoral Venous Outflow Obstruction

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